Primary adherence to controller medications for asthma is poor

Ann Chen Wu, Melissa G. Butler, Lingling Li, Vicki Fung, Elyse O. Kharbanda, Emma K. Larkin, William M. Vollmer, Irina Miroshnik, Robert Davis, Tracy A. Lieu, Stephen B. Soumerai

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Abstract

Rationale: Few previous studies have evaluated primary adherence (whether a new prescription is filled within 30 d) to controller medications in individuals with persistent asthma. Objective: To compare adherence to the major controller medication regimens for asthma. Methods: This was a retrospective cohort study of enrollees from five large health plans. Weused electronic medical data on patients of all ages with asthma who had experienced an asthma-related exacerbation in the prior 12 months.Westudied adherence measures including proportion of days covered and primary adherence (first prescription filled within 30 d). Measurements and Main Results: Our population included 69,652 subjects who had probable persistent asthma and were prescribed inhaled corticosteroids (ICSs), leukotriene antagonists (LTRAs), or ICS/long-acting b-agonists (ICS/LABAs). The mean age was 37 years and 58% were female.Wefound that 14-20% of subjects who were prescribed controller medicines for the first time did not fill their prescriptions. The mean proportion of days covered was 19% for ICS, 30% for LTRA, and 25% for ICS/LABA over 12 months. Using multivariate logistic regression, subjects prescribedLTRAwere less likely to be primary adherent than subjects prescribed ICS (odds ratio, 0.82; 95% confidence interval, 0.74-0.92) or ICS/LABA (odds ratio, 0.88; 95% confidence interval, 0.80-0.97). Black and Latino patients were less likely to fill the prescription compared with white patients. Conclusions: Adherence to controller medications for asthma is poor. In this insured population, primary adherence to ICSswas better than toLTRAs and ICS/LABAs.Adherence asmeasured by proportion of days covered was better for LTRAs and ICS/LABAs than for ICSs.

Original languageEnglish (US)
Pages (from-to)161-166
Number of pages6
JournalAnnals of the American Thoracic Society
Volume12
Issue number2
DOIs
StatePublished - Feb 1 2015

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Adrenal Cortex Hormones
Asthma
Leukotriene Antagonists
Prescriptions
Odds Ratio
Medical Electronics
Confidence Intervals
Hispanic Americans
Population
Cohort Studies
Retrospective Studies
Logistic Models
Health

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine

Cite this

Wu, A. C., Butler, M. G., Li, L., Fung, V., Kharbanda, E. O., Larkin, E. K., ... Soumerai, S. B. (2015). Primary adherence to controller medications for asthma is poor. Annals of the American Thoracic Society, 12(2), 161-166. https://doi.org/10.1513/AnnalsATS.201410-459OC

Primary adherence to controller medications for asthma is poor. / Wu, Ann Chen; Butler, Melissa G.; Li, Lingling; Fung, Vicki; Kharbanda, Elyse O.; Larkin, Emma K.; Vollmer, William M.; Miroshnik, Irina; Davis, Robert; Lieu, Tracy A.; Soumerai, Stephen B.

In: Annals of the American Thoracic Society, Vol. 12, No. 2, 01.02.2015, p. 161-166.

Research output: Contribution to journalArticle

Wu, AC, Butler, MG, Li, L, Fung, V, Kharbanda, EO, Larkin, EK, Vollmer, WM, Miroshnik, I, Davis, R, Lieu, TA & Soumerai, SB 2015, 'Primary adherence to controller medications for asthma is poor', Annals of the American Thoracic Society, vol. 12, no. 2, pp. 161-166. https://doi.org/10.1513/AnnalsATS.201410-459OC
Wu, Ann Chen ; Butler, Melissa G. ; Li, Lingling ; Fung, Vicki ; Kharbanda, Elyse O. ; Larkin, Emma K. ; Vollmer, William M. ; Miroshnik, Irina ; Davis, Robert ; Lieu, Tracy A. ; Soumerai, Stephen B. / Primary adherence to controller medications for asthma is poor. In: Annals of the American Thoracic Society. 2015 ; Vol. 12, No. 2. pp. 161-166.
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abstract = "Rationale: Few previous studies have evaluated primary adherence (whether a new prescription is filled within 30 d) to controller medications in individuals with persistent asthma. Objective: To compare adherence to the major controller medication regimens for asthma. Methods: This was a retrospective cohort study of enrollees from five large health plans. Weused electronic medical data on patients of all ages with asthma who had experienced an asthma-related exacerbation in the prior 12 months.Westudied adherence measures including proportion of days covered and primary adherence (first prescription filled within 30 d). Measurements and Main Results: Our population included 69,652 subjects who had probable persistent asthma and were prescribed inhaled corticosteroids (ICSs), leukotriene antagonists (LTRAs), or ICS/long-acting b-agonists (ICS/LABAs). The mean age was 37 years and 58{\%} were female.Wefound that 14-20{\%} of subjects who were prescribed controller medicines for the first time did not fill their prescriptions. The mean proportion of days covered was 19{\%} for ICS, 30{\%} for LTRA, and 25{\%} for ICS/LABA over 12 months. Using multivariate logistic regression, subjects prescribedLTRAwere less likely to be primary adherent than subjects prescribed ICS (odds ratio, 0.82; 95{\%} confidence interval, 0.74-0.92) or ICS/LABA (odds ratio, 0.88; 95{\%} confidence interval, 0.80-0.97). Black and Latino patients were less likely to fill the prescription compared with white patients. Conclusions: Adherence to controller medications for asthma is poor. In this insured population, primary adherence to ICSswas better than toLTRAs and ICS/LABAs.Adherence asmeasured by proportion of days covered was better for LTRAs and ICS/LABAs than for ICSs.",
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AU - Wu, Ann Chen

AU - Butler, Melissa G.

AU - Li, Lingling

AU - Fung, Vicki

AU - Kharbanda, Elyse O.

AU - Larkin, Emma K.

AU - Vollmer, William M.

AU - Miroshnik, Irina

AU - Davis, Robert

AU - Lieu, Tracy A.

AU - Soumerai, Stephen B.

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N2 - Rationale: Few previous studies have evaluated primary adherence (whether a new prescription is filled within 30 d) to controller medications in individuals with persistent asthma. Objective: To compare adherence to the major controller medication regimens for asthma. Methods: This was a retrospective cohort study of enrollees from five large health plans. Weused electronic medical data on patients of all ages with asthma who had experienced an asthma-related exacerbation in the prior 12 months.Westudied adherence measures including proportion of days covered and primary adherence (first prescription filled within 30 d). Measurements and Main Results: Our population included 69,652 subjects who had probable persistent asthma and were prescribed inhaled corticosteroids (ICSs), leukotriene antagonists (LTRAs), or ICS/long-acting b-agonists (ICS/LABAs). The mean age was 37 years and 58% were female.Wefound that 14-20% of subjects who were prescribed controller medicines for the first time did not fill their prescriptions. The mean proportion of days covered was 19% for ICS, 30% for LTRA, and 25% for ICS/LABA over 12 months. Using multivariate logistic regression, subjects prescribedLTRAwere less likely to be primary adherent than subjects prescribed ICS (odds ratio, 0.82; 95% confidence interval, 0.74-0.92) or ICS/LABA (odds ratio, 0.88; 95% confidence interval, 0.80-0.97). Black and Latino patients were less likely to fill the prescription compared with white patients. Conclusions: Adherence to controller medications for asthma is poor. In this insured population, primary adherence to ICSswas better than toLTRAs and ICS/LABAs.Adherence asmeasured by proportion of days covered was better for LTRAs and ICS/LABAs than for ICSs.

AB - Rationale: Few previous studies have evaluated primary adherence (whether a new prescription is filled within 30 d) to controller medications in individuals with persistent asthma. Objective: To compare adherence to the major controller medication regimens for asthma. Methods: This was a retrospective cohort study of enrollees from five large health plans. Weused electronic medical data on patients of all ages with asthma who had experienced an asthma-related exacerbation in the prior 12 months.Westudied adherence measures including proportion of days covered and primary adherence (first prescription filled within 30 d). Measurements and Main Results: Our population included 69,652 subjects who had probable persistent asthma and were prescribed inhaled corticosteroids (ICSs), leukotriene antagonists (LTRAs), or ICS/long-acting b-agonists (ICS/LABAs). The mean age was 37 years and 58% were female.Wefound that 14-20% of subjects who were prescribed controller medicines for the first time did not fill their prescriptions. The mean proportion of days covered was 19% for ICS, 30% for LTRA, and 25% for ICS/LABA over 12 months. Using multivariate logistic regression, subjects prescribedLTRAwere less likely to be primary adherent than subjects prescribed ICS (odds ratio, 0.82; 95% confidence interval, 0.74-0.92) or ICS/LABA (odds ratio, 0.88; 95% confidence interval, 0.80-0.97). Black and Latino patients were less likely to fill the prescription compared with white patients. Conclusions: Adherence to controller medications for asthma is poor. In this insured population, primary adherence to ICSswas better than toLTRAs and ICS/LABAs.Adherence asmeasured by proportion of days covered was better for LTRAs and ICS/LABAs than for ICSs.

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